Uneven swelling and bruising may be the result of bleeding, which would require a prompt decompression. Uneven swelling later in the postoperative course may signify an infection, which is treated via antibiotics and possibly drainage. Cloudy drainage, fever, or spreading redness all point to an infection as well. A less common cause of late uneven (unilateral swelling) has been called a parotid fistula (though not really a fistula but more of a salivary collection under the facial skin flap resulting from shave of the superficial portion of the parotid gland). This is normally a self-limiting nuisance more than a significant clinical issue.
Jacob Gerzenshtein, MD, FACS,
A Board Certified Plastic Surgeon
